原发性腹膜后脂肪肉瘤MSCT影像学征象分析

Analysis of the MSCT Imaging Signs of Primary Retroperitoneal Liposarcoma

目的分析原发性腹膜后脂肪肉瘤MSCT影像学征象,提高对该病的认识与诊断准确率。方法回顾性分析我院2017年3月至2019年4月收治的40例原发性腹膜后脂肪肉瘤患者的临床资料,观察MSCT检查所得结果进行诊断分析;观察肿瘤发生的部位、肿块大小、形态、密度、边界及增强扫描后强化方式和程度等;观察邻近组织器官的变化及远处转移情况。结果肿瘤直径大小18cm×22cm×28cm至6cm×12cm×15cm。15例高分化脂肪肉瘤,以脂肪密度肿块为主,不均匀,有网状分隔、无脂肪成分的等密度、低密度肿物,边缘较模糊。17例黏液型脂肪肉瘤,其中呈7例囊样改变,有分隔,边界较清晰,10例肿块呈棉絮样,密度较低,边界模糊。6例去分化型脂肪肉瘤,混合性肿块,有2例内部脂肪成分较少,与软组织影分界不清,1例有明显界限。2例圆形细胞型脂肪肉瘤。40例患者中,有26例患者的肿块邻近组织器官受到不同程度的压迫,8例腹腔和腹膜后淋巴结伴有肿大,6例患者发现肝内转移。结论MSCT检查可清楚显示原发性腹膜后脂肪肉瘤的影像学特点,对肿瘤的定位、定性诊断及判断肿瘤与邻近组织器官的关系具有重要的价值,有利于提高诊断准确率。

Objective To analyze the MSCT imaging signs of primary retroperitoneal liposarcoma and to improve the u n d e rstanding and diagnostic accuracy of the disease.Method The clinical data of 40 patients with primary retroperitoneal liposarcoma admitted from March 2017 to April 2019 in our hospital were retrospectively analyzed.The results of the MSCT exa mination were observed for diagnostic analysis.The location,size,shape,density,the bounda ry of the tumor,and the way and extent of enhancement after scanning were observed.Changes in adjacent tissues and organs and distant metastasis were also observed.Result The tumor has a diameter of 18 cm×22 cm×28 cm to 6 cm×12 cm×15 cm.15 cases of well-differentiated liposa rcoma,mainly fat density lumps,uneven,and there were Isoba ric and low-density mass with reticular,fat-free ingredients,the edges were blurry.Of the 17 cases of mucinous liposarcoma,7 of them had cystic changes,separated,and the borders were clear.Ten of the masses were cotton-like,with low density and blurred boundaries.6 cases of dedifferentiated liposarcoma,mixed mass,2 cases with less internal fat components and unclear boundaries with soft tissue,1 case had obvious boundaries.2 cases of round cell type liposa rcoma.Of the 40 patients,26 had a different degree of compression in the adjacent tissues and organs,8 had abdominal and retroperitoneal lymph nodes with swelling,and 6 patients found intrahepatic metastases.Conclusion MSCT examination can clearly show the imaging features of primary retroperitoneal liposarcoma,which is of great value for tumor localization,qualitative diagnosis and judging the relationship between tumor and adjacent tissues and organs,which is conducive to improving the diagnostic accu racy.